Root Canal Treatment

Root canal therapy is the treatment used to save and repair a tooth that is badly infected or decayed. It is also performed when the pulp of the tooth (which is made up of blood vessels and nerves) becomes damaged or infected. When a root canal therapy is performed, the pulp of the tooth is removed, the inside is cleaned and then sealed.

There is a common misconception that root canals are painful so many people are afraid of the procedure. However, in actuality, root canals are no more painful than getting a dental filling.

Why do I need a root canal treatment?

Some of the signs you need root canal therapy include:
– Severe toothache when chewing or when pressure is applied.
– Prolonged pain or sensitivity to cold or hot temperatures.
– Darkening or discoloration of the tooth.
– A small, pimple-like bump known as an abscess on the gums near the area of teeth pain
– Increased tooth mobility, due to loosening of tooth

What can I expect during a root canal treatment?

Root canal therapy will often require one or multiple visits. The root canal procedure can be carried out by a dentist or an endodontist. A dentist who specializes in the diagnosis, prevention, causes, and treatment of injuries and diseases of the dental pulp of the teeth is called an endodontist.

Your choice in terms of the type of dentist you will pick to perform the root canal procedure will depend to a certain degree on the level of difficulty needed in your case.

The root canal procedure will start with an X-ray taken so the dentist can see the shape of the root canals. The X-ray can also help the dentist check for any signs of infections in the surrounding bone.

In order to numb the area surrounding the tooth, your dentist or endodontist will use local anaesthesia. Anaesthesia however is not really required since the nerve is dead. Many dentists still choose to use anaesthesia though to help patients relax and feel at ease during the root canal procedure.

To ensure the area is dry and free of saliva during the procedure, a rubber dam will be placed around the tooth. An access hole is then drilled into the tooth. The pulp, alongside debris and bacteria is removed during the root canal procedure.

The cleaning-out process is done using root canal files. A series of files of various diameters are subsequently placed in the access hole to scrub and scrape the sides of the root canals. Sodium hypochlorite or water is periodically used by the dentist to flush any remaining debris away.

Once the tooth has been cleaned thoroughly, it is then sealed. In some cases, however, dentists will wait for at least a week before sealing the tooth. This is often the case when there is an infection in the root canal. The dentist may need to put medication in the affected tooth to clear it up first before sealing.

If there are no issues, the tooth is often sealed after it is cleaned out. If the root canal treatment is not completed on the same day by your dentist, a temporary dental filling is placed in the tooth’s exterior hole to ensure contaminants are kept out in between dental appointments.

On the next dental appointment, a rubber compound called gutta-percha and a sealer paste are used to fill the tooth’s interior. To fill the exterior access hole, a filling is also placed.

The final step can involve further tooth restoration after the root canal procedure.

Since a tooth given the root canal therapy treatment often has extensive decay, large filling, and other weaknesses, a crown, crown and post, or other restoration might be needed to restore the tooth’s full function and prevent it from breaking. Any additional work will be discussed by your dentist.

Are there any discomforts after root canal treatment?

Until the entire root canal procedure has been completed, it is recommended that you minimise the use of the repaired tooth. Doing so will help ensure the interior of the tooth is not contaminated and that the tooth being repaired will not break when it has not been restored fully yet.

The first few days after the root canal procedure, the repaired tooth might feel sensitive because of natural tissue inflammation. This is especially true if there was infection or pain prior to the dental implant procedure.

Fortunately, the discomfort or sensitivity can be easily remedied using over-the-counter pain medications like naproxen (Aleve) or ibuprofen (Motrin or Advil). Most patients can already resume doing their normal daily activities the next day after the root canal procedure.

In terms of oral health, floss and brush as you regularly would and pay your dentist a visit at scheduled intervals. Since the final step of root canal therapy is restoration, it will not be obvious that you have had a root canal done.

Root canal therapy is highly successful, with more than 95 percent in terms of success rate. Many teeth repaired using the root canal procedure can last a lifetime.

What are some possible root canal complications?

What are some potential/possible post-root canal treatment problems/complications?

In some cases, new infections can emerge after your root canal treatment, despite your dentist’s best efforts. Some of the likely reasons for this happening include:

There’s more than the anticipated number of root canals and some of them have been left uncleaned.
There is an undetected crack in the tooth’s root, which can render the root canal treatment ineffective
An inadequate or defective dental restoration has allowed bacteria into the tooth’s inner aspects and re-contaminated the dental canal area.
The inner sealing broke down overtime, allowing bacteria to contaminate the tooth.

In some instances, root canal re-treatment might be necessary. In other cases, endodontic surgery will be carried out to save the tooth. The most prevalent endodontic surgical procedure is root-end resection or apicoectomy.

Apicoectomy is a procedure done to relieve infection or inflammation in the bony area situated around the end of the tooth. In the procedure, the gum tissue is opened, and the tissue that is infected is removed. In some cases, the very end of the tooth’s root known as the apex, is also removed. To seal the root canal, a small dental filling may be placed.

What are some possible alternatives to root canal treatment?

When possible, saving your natural teeth is the best alternative. That natural teeth makes it possible for you to eat a vast variety of foods needed to retain proper nutrition. That is the reason root canal therapy is a top treatment option.

Since inflammation and deep decay are some of the primary reasons for needing root canal therapy, regular dental procedures, good oral hygiene practices, and regular dental visits can help minimise the need for the procedure.

The only alternate option to a root canal procedure is tooth extraction. To restore chewing function and ensure the adjacent teeth does not shift, the extracted tooth is replaced with either an implant, bridge, or removable denture.

Compared to root canal, the aforementioned alternatives are not only more costly, they also require more treatment time as well as possible additional procedures done to the supporting tissues as well as the adjacent teeth.

However, these alternatives can be more suited to your needs depending on your preferences and your dentist’s recommendations. For instance, if a fracture line extends deep into the gum, the tooth is generally not restorable through root canal treatment and has to be extracted and replaced with a dental implant instead. Hence, it is important to consider all the other options, starting from dental implants which you can find out more here.

Frequently Asked Questions about Root Canal Treatment

How long will a tooth last after root canal therapy?

The restored tooth can last a lifetime as long as you continue to care for both your teeth and gums. Regular visits to your dentist is also necessary. Given that the root of the repaired tooth is nourished by the surrounding tissues, your tooth can stay healthy.

Can root canal procedures be redone?

As long as proper care is observed, teeth treated using root canal therapy can last indefinitely. However, tooth that has not been treated or cared for accordingly can become diseased or painful months (or even years) after the procedure. In similar scenarios, additional procedure may be needed to support the tooth’s healing.

Can root canal therapy relieve tooth pain?

Severe tooth pain is sometimes attributed to damaged tissues in the tooth. Fortunately, it can be remedied by removing the damaged tissue through root canal therapy. In addition, since dentists are experts in pain management, they can easily relieve tooth pain easily and quickly.

When is root canal treatment necessary?

Some of the signs that indicate a root canal treatment might be necessary include: severe tooth pain when eating or when pressure is placed on the area, sensitivity to hot or cold, and swelling or tenderness in the gums near the affected tooth.

Will the affected tooth hurt after root canal therapy?

One of the primary goals of root canal therapy is total nerve removal, therefore the tooth itself will no longer be sensitive. However, when the procedure causes irritation to the surrounding tissues, it can result to sensitivity. In some cases, sensitivity after the procedure can be attributed to inflammation and swelling from a pre-existing infection.

Is extraction a better alternative?

When possible, saving your natural teeth is always the best option. Nothing is better than your natural teeth. At times, an artificial tooth can sometimes hinder you from eating certain foods.

Keeping your natural teeth is important so you can continue to enjoy foods that are needed to maintain proper nutrition. If extraction is recommended, check if root canal treatment can be a possible remedy.

Can root canal treatment be avoided?

The best way to avoid root canal treatment is to prevent tooth decay. In some cases however, a root cannot is considered the ideal alternative. Teeth damaged from deep decay, advanced gum disease, or damaged because of trauma can all result to an infected tooth that might require root canal therapy.

Is root canal treatment painful?

Pain usually felt is often attributed to the injury or infection in the tooth and not the procedure itself. On the contrary, root canal therapy (also known as endodontic therapy) is done to eliminate pain. Thanks to advances in modern medicine, a root canal procedure is painless.

Is it possible for a root canal to be infected again?

If a root canal gets infected again after a root canal procedure has been done, it can be because of a problem near the root’s apex. The dentist can do an apicoectomy so there is no need to extract the tooth. In most cases however, a second root canal treatment is performed before an apicoectomy is considered.

What is dental pulp?

The soft area situated within the tooth’s center is called the pulp or pulp chamber. It contains blood vessels, nerve, and connective tissue. The nerve of the tooth is located in the “root” or “legs” of the tooth. The root canal travels from the tip of the root of the tooth into the pulp chamber.

The nerve of the tooth does not really play a vital role in the tooth’s function and health after it has emerged through the gums. Essentially, its only function is sensory. In other words, it provides the sensation of heat or cold.

The presence (or absence) of the tooth’s nerve will not in any way affect the tooth’s day-to-day function. After a root canal therapy is done however, the tooth is less viable and more prone to fracture.

What causes damage to the tooth pulp?

The pulp of the tooth can become inflamed, infected, and irritated due to large fillings, deep decay, or a chip or crack in the tooth. Repeated dental procedures on the tooth as well as trauma to the face are also likely causes.

Why is it important to remove the pulp?

When damaged, the pulp will eventually break down. When it happens, bacteria can set in and multiply within the pulp chamber. Other dying pulp remnants and bacteria can also result to abscessed tooth or infection. A pus-filled pocket that forms at the end of the tooth’s root is called abscess. Aside from abscess, a root canal infection can also cause:

Swelling that can spread to other areas of the neck, head, or face.
Bone loss around the root’s tip.
Drainage problems that extend outward from the tooth’s root.